<%@ page language="java" contentType="text/html; charset=UTF-8" pageEncoding="UTF-8"%>
<%@page import="com.jaxplat.commons.Row" %>
<%@page import="com.jaxplat.commons.RowImpl" %>
<%
	String contextPath = request.getContextPath();
	Row dsInfo = new RowImpl();
	if(null != request.getAttribute("dsInfo"))
	{
	    dsInfo =(Row)request.getAttribute("dsInfo");
	}
	java.util.List validateResult = null;
	if(null != request.getAttribute("validateResult"))
	{
	    validateResult =(java.util.List)request.getAttribute("validateResult");
	}
	String idNo= (null == request.getAttribute("id_no")) ? "" : (String)request.getAttribute("id_no");
	// String idType= (null == request.getAttribute("id_type")) ? "" : (String)request.getAttribute("id_type");
	String applicantName= (null == request.getAttribute("applicant_name")) ? "" : (String)request.getAttribute("applicant_name");
	String gender =  (null == request.getAttribute("gender")) ? "" : (String)request.getAttribute("gender");
	String mobileNo =  (null == request.getAttribute("mobile_no")) ? "" : (String)request.getAttribute("mobile_no");
	String birthYear =  (null == request.getAttribute("birth_year")) ? "" : (String)request.getAttribute("birth_year");
	String birthMonth  =  (null == request.getAttribute("birth_month")) ? "" : (String)request.getAttribute("birth_month");
	 
	
%>
<!DOCTYPE html PUBLIC "-//WAPFORUM//DTD XHTML Mobile 1.0//EN" "http://www.wapforum.org/DTD/xhtml-mobile10.dtd">
<head>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<title>填写预约-无线城市  预约挂号</title>
<link type="text/css"  href="http://183.224.40.27/wxcs/common/css.css" rel="stylesheet" />
<link type="text/css"  href="http://183.224.40.27/wxcs/component/xuanban/css/style.css" rel="stylesheet" />
<link type="text/css"  href="../css/h_wap.css" rel="stylesheet" />
</head>
<body>
<!-- <iframe width="100%" frameborder="0" scrolling="no" style="border:0px none;" src="http://wap.ynicity.cn/wxcs/common/xuanban/header.jsp"></iframe>
 --><div class="wap">
<p style="background: url(http://183.224.40.27/wxcs/upload/images/main_nav_bg.gif) repeat-x scroll left top transparent; font-size:14px; font-variant:1.8; font-weight:bolder; color:#FFF;padding:3px 5px;">
	<a class="back" href="<%=request.getContextPath()%>/wap/index.jsp">首页</a>
	&gt;
	<a class="back" href="<%=request.getContextPath()%>/ivr/doctorToIvrAction.do?method=initSearch_s1">预约挂号</a>
	&gt;
	填写预约
</p>
  <div class="photo_prcoess frist"></div>
  <div class="marginAout w240">
    <form name="form1" method="post" action="<%=request.getContextPath()%>/ivr/reserve.do?method=confirm">
    <p><strong>预约基本信息</strong></p>
      <table class="wapTable" border="0">
        <tbody>
          <tr>
            <td>专家名称：</td>
            <td>
            	<%=dsInfo.getString("doctor_name") %>
            	<input id="ds_id" name="ds_id" type="hidden" value="<%=dsInfo.getLong("ds_id") %>" /> 
            	<input id="doctor_id" name="doctor_id" type="hidden" value="<%=dsInfo.getLong("doctor_id") %>" /> 
            </td>
          </tr>
          <tr>
            <td> 专家职称： </td>
            <td>
            	<%=dsInfo.getString("pro_title_name") %>
            	<input id="pro_title" name="pro_title" type="hidden" value="<%=dsInfo.getString("pro_title") %>" /> 
            </td>
          </tr>
          <tr>
            <td> 所属科室： </td>
            <td>
            	<%=dsInfo.getString("sec_name") %>
            	<input id="section_id" name="section_id" type="hidden" value="<%=dsInfo.getString("sec_name") %>" /> 
            </td>
          </tr>
          <tr>
            <td>医院名称： </td>
            <td>
            	<%=dsInfo.getString("hos_name") %>
            </td>
          </tr>
          <tr>
            <td>就诊时间： </td>
            <td>
            	<%=com.jaxplat.util.DateUtils.parseDate( dsInfo.getDate("sc_date")) %> &nbsp;<%=dsInfo.getString("batch_name")%>
            </td>
          </tr>
        </tbody>
      </table>
    <p class="line_wap">&nbsp;</p>
     <p><strong>患者基本信息（以下信息必须填写）</strong></p>
      <table class="wapTable usable" border="0">
        <tbody>
          <tr>
            <td>身份证号码：</td>
            <td>
            	<input type="text"  name="id_no" value="" 
            		style="width:150px;"  class="bgcolor" maxlength="20" />*
            </td>
          </tr>
          <tr>
            <td> 患者姓名： </td>
            <td>
            	<input type="text"  name="applicant_name" style="width:150px;" class="bgcolor" maxlength="20" >*
            </td>
          </tr>
          <tr>
            <td>性别： </td>
            <td>
            	<input type="radio" name="gender" value="m" checked="checked" /> 男
            	<input type="radio" name="gender" value="f"  /> 女*
			</td>
          </tr>
          <tr>
            <td>手机号码： </td>
            <td>
            	<input type="text"  name="mobile_no" style="width:150px;" class="bgcolor" maxlength="11"  />*
            </td>
          </tr>
          <tr>
          <tr>
            <td>出生年月： </td>
            <td>
            	<input type="text"  name="birth_year" style="width:50px;" class="bgcolor" maxlength="4"  />年
	              <select name="birth_month">
	              	<%
	              	for(int monthIdx=1; monthIdx<=12; monthIdx++)
	              	{
	              	%>
	                <option value="<%=monthIdx %>" selected="true">&nbsp;<%=monthIdx %>&nbsp;</option>
	                <%
	              	}
	                %>
	              </select>月*
            </td>
          </tr>
          <tr>
            <td></td>
            <td> 
            	<input name="submit" type="submit" value="提&nbsp;&nbsp;交"  class="btn" />
            </td>
          </tr>
        </tbody>
      </table>
      <div style="color:#ff0000;">
      	<%
      	if(null != validateResult && validateResult.size() > 0)
      	{
      	    for(int i=0; i < validateResult.size(); i++)
      	    {
      	%>
      		 <p ><%=validateResult.get(i).toString() %></p>
      	<%
      	    }
      	}
      	%>
      </div>
      <p class="line_wap">&nbsp;</p>
	  <p class="back_index_link">
			<a class="back" href="<%=contextPath%>/ivr/searchMyReserve.jsp">我的预约</a>
	  </p>
    </form>
  </div>
</div>
<!-- <iframe width="100%" frameborder="0" scrolling="no" style="border: 0px none;" src="http://wap.ynicity.cn/wxcs/common/xuanban/footer.jsp"> </iframe>
 --></body>
</html>